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Severe tricuspid regurgitation after repair of ventricular septal defect
ABSTRACTS
994
Balloon Occlusion of a Persibtent Left Superior Vcna Cava in the Preoperative Evaluation of Systemic Vrnouc Return. ,II.D. Freed, :I. Roswffhol. atId ll!F. BWI//~lo,?YI..I. Thorac~. Cardiovasc. Surg. 65:835-839 (May) 1973. Preoperative evaluation of the feasibility of ligation of 3 persistent left superior vcna cava during the course of repair of congenital heart disease is presented. By passing an end-hole balloon catheter into the left superior vena cava and occluding the vein by inflating the balloon, the pressure in the obstructed vein can be measured. It’ the pressure does not return to normal in IS or 20 min. it may be concluded that the ligation of the vein could result in poqtoperative cerebral edema.-TIlornas !Zt Holder Severe Tricuspid Regurgitation After Repair of Ventricular Septal Defect. R.D. Fidwr, R.K. Brawlql, C. A. !Veill, J.S. Dmahoo, J.A. Hailer, R.D. Rowe, a,jd P./.. Got?. J. Thorac. Cardiovast. Surg. 65: 702-707 (.Clay 1 1973. Sis patients \vho developed incapacitating right-heart failure due to tricucpid Insufficiency after repair of a ventricular septal defect are was due to presented. in three the defect operative injury to the tricuspid valve, chordae tendineae, or papillary muscles. They were treated by tricuspid valve replacement. In the other three, tricuspid insufficiency was sccondary to right-heart failure with dilatation of the tricuspid annulus. Thih secondary tricuspid insufficiency can be produced by surgical division of important coronary arteries with resulting ischemia. from infundibular infarction after estensive infundibular resection. and volu~~~c and pressure overload of the right ventricle secondary to residual outflow tract obstruction, pulmonary insufficiency, and residual shunt. Tht
ALIMENTARY The Surgical Treatment of Diaphragmatic Oesophageal Hiatus Hernia. Ker~~etl~ S. Midlard. Ann. R. Cull. Surp. l&l. 50:73, 1972. The various etiological factors of hiatuh hernia are considered under the headings ot Mechanical Isactors, Disorder5 of Secretion. and Disorders of Motility. Great stress is hid on the fact that longitudinal pull is probably an important etiological factor in hiatus hernia. The results are analyzed in relation to the abolish-
first group does well with tricuspid valve; the latter tricuspid
insufficiency
replacement does not.
is detected
of the Primary
by catheter-
ization and angiocardiography showing normal right-ventricle pressure, lack of residual shunt, Jnd an active right ventricular contraction. Thomas Al. Holder Atrial
hlyxoma.
J. Thoruc. (May) I 973.
XX Kabbatri lrr~dD..-1. Cooic~~~. Cardiovasc.
Surg.
65:731-737
A technique for removal of atrial my\omas which minimizes intraoperative embolization of the tumor and prevention of recurrence as well as providing access for thorough exploration of the heart to detect occasional multiple tumor> is presented. After bypass is established, the left atrium is opened and the tumor inspected but not manipulated. The right atrium is then opened and the atrial septum with the tumor attachment in the region of the fossa ovale is excised. The tumor is removed and the heart irrigated with saline and the septal defect patched. Seventeen patients are presented. There was one death. The method described was used in three paticnt~.-T/lo,,fas ,\I. Holdu Gastrointestinal Bleeding after Open-Heart Surgery. G.F. Il’c,lslr. R.R. Doxis, L. G. Bartholormw, A.1,. Rrowl, Jr., umi G.K. Da~rielw~. J. Thorac~. Cardiovasc. Surg. 65: 738-743 (May) 1973. Of the 7333 patients undergoing cardiopulmonary bypass, 16 had significant postoperative gastrointestinal bleeding. Thirteen died. OnI) one of the 16 patients had congenital heart disease. Significant gastrointestinal bleeding at’ter cardiopulmonary bypass is rare in infants and children. ~ Tilorms ill. Holder
TRACT ment of longitudinal ~“111by multiple transverse myotomies or by the use of colonic or jejunal interpositions. The causes of failure in the different methods of treatment are analyzed. There were 39 fvilurrs in all types of cases m the 700 patients treated. Nine of these patient< died; I2 have failed to obtain relief of symptams in spite of an anatomically Tound repair. Of the I8 remaining failures eight were due to miscellaneous causes and ten due to esophageal Fhortening. It is clear that shortening is an inportant cause of failure. One must look for this
994
Balloon Occlusion of a Persibtent Left Superior Vcna Cava in the Preoperative Evaluation of Systemic Vrnouc Return. ,II.D. Freed, :I. Roswffhol. atId ll!F. BWI//~lo,?YI..I. Thorac~. Cardiovasc. Surg. 65:835-839 (May) 1973. Preoperative evaluation of the feasibility of ligation of 3 persistent left superior vcna cava during the course of repair of congenital heart disease is presented. By passing an end-hole balloon catheter into the left superior vena cava and occluding the vein by inflating the balloon, the pressure in the obstructed vein can be measured. It’ the pressure does not return to normal in IS or 20 min. it may be concluded that the ligation of the vein could result in poqtoperative cerebral edema.-TIlornas !Zt Holder Severe Tricuspid Regurgitation After Repair of Ventricular Septal Defect. R.D. Fidwr, R.K. Brawlql, C. A. !Veill, J.S. Dmahoo, J.A. Hailer, R.D. Rowe, a,jd P./.. Got?. J. Thorac. Cardiovast. Surg. 65: 702-707 (.Clay 1 1973. Sis patients \vho developed incapacitating right-heart failure due to tricucpid Insufficiency after repair of a ventricular septal defect are was due to presented. in three the defect operative injury to the tricuspid valve, chordae tendineae, or papillary muscles. They were treated by tricuspid valve replacement. In the other three, tricuspid insufficiency was sccondary to right-heart failure with dilatation of the tricuspid annulus. Thih secondary tricuspid insufficiency can be produced by surgical division of important coronary arteries with resulting ischemia. from infundibular infarction after estensive infundibular resection. and volu~~~c and pressure overload of the right ventricle secondary to residual outflow tract obstruction, pulmonary insufficiency, and residual shunt. Tht
ALIMENTARY The Surgical Treatment of Diaphragmatic Oesophageal Hiatus Hernia. Ker~~etl~ S. Midlard. Ann. R. Cull. Surp. l&l. 50:73, 1972. The various etiological factors of hiatuh hernia are considered under the headings ot Mechanical Isactors, Disorder5 of Secretion. and Disorders of Motility. Great stress is hid on the fact that longitudinal pull is probably an important etiological factor in hiatus hernia. The results are analyzed in relation to the abolish-
first group does well with tricuspid valve; the latter tricuspid
insufficiency
replacement does not.
is detected
of the Primary
by catheter-
ization and angiocardiography showing normal right-ventricle pressure, lack of residual shunt, Jnd an active right ventricular contraction. Thomas Al. Holder Atrial
hlyxoma.
J. Thoruc. (May) I 973.
XX Kabbatri lrr~dD..-1. Cooic~~~. Cardiovasc.
Surg.
65:731-737
A technique for removal of atrial my\omas which minimizes intraoperative embolization of the tumor and prevention of recurrence as well as providing access for thorough exploration of the heart to detect occasional multiple tumor> is presented. After bypass is established, the left atrium is opened and the tumor inspected but not manipulated. The right atrium is then opened and the atrial septum with the tumor attachment in the region of the fossa ovale is excised. The tumor is removed and the heart irrigated with saline and the septal defect patched. Seventeen patients are presented. There was one death. The method described was used in three paticnt~.-T/lo,,fas ,\I. Holdu Gastrointestinal Bleeding after Open-Heart Surgery. G.F. Il’c,lslr. R.R. Doxis, L. G. Bartholormw, A.1,. Rrowl, Jr., umi G.K. Da~rielw~. J. Thorac~. Cardiovasc. Surg. 65: 738-743 (May) 1973. Of the 7333 patients undergoing cardiopulmonary bypass, 16 had significant postoperative gastrointestinal bleeding. Thirteen died. OnI) one of the 16 patients had congenital heart disease. Significant gastrointestinal bleeding at’ter cardiopulmonary bypass is rare in infants and children. ~ Tilorms ill. Holder
TRACT ment of longitudinal ~“111by multiple transverse myotomies or by the use of colonic or jejunal interpositions. The causes of failure in the different methods of treatment are analyzed. There were 39 fvilurrs in all types of cases m the 700 patients treated. Nine of these patient< died; I2 have failed to obtain relief of symptams in spite of an anatomically Tound repair. Of the I8 remaining failures eight were due to miscellaneous causes and ten due to esophageal Fhortening. It is clear that shortening is an inportant cause of failure. One must look for this